scholarly journals Correlation between antibiotic consumption and bacterial resistance as quality indicator of proper use of these drugs in inpatients

2009 ◽  
Vol 66 (4) ◽  
pp. 307-312 ◽  
Author(s):  
Radmila Velickovic-Radovanovic ◽  
Jasmina Petrovic ◽  
Branislava Kocic ◽  
Snezana Antic ◽  
Gordana Randjelovic
Keyword(s):  
Bacterial Resistance ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
E Coli ◽  
Defined Daily Doses ◽  
Clinical Center ◽  
Rational Drug ◽  
Antibiotics Use ◽  
Amoxicillin Clavulanic Acid ◽  
Investigation Period

Background/Aim. Antibiotics are the most frequently used medications in Serbian hospitalized patients. Information about antibiotic utilization and sensitivity among inpatients in Serbia is scanty, and there are no available publications on the topic. The aim of this study was to investigate the correlation between antibiotic use and bacterial resistance in the Clinical Center Nis, one of the biggest hospitals in Serbia. Methods. The data on antibiotics use in inpatients were obtained from the database of the Department of Pharmacotherapy and expressed as defined daily doses per 100 bed-days (DBD), during 2003-2007. Bacterial resistances were given as percentages of resistant isolates. Results. During the investigation period, the overall consumption of antibiotics had a significant decrease in 2007, by 22.99% (62.23 : 47.92 DBD; p < 0.05). The most frequently used antibiotics were cephalosporins, followed by penicillin's, aminoglycosides and quinolones. Hospital aminoglycosides consumption was reduced in 2007 to 59.9% (13.4 : 5.53 DBD) while the resistance to amikacin was reduced from 40.88% to 32.1%. However, utilization of ciprofloxacin had a significant increase in 2007 (120.7%). There was an alarming increase in the level of resistance to ciprofloxacin in our hospital (from 13.5% to 28.3 % in Escherichia coli and from 11.1 to 30.09% in Proteus mirabilis). Reduction of E coli resistant to amoxicillin+clavulanic acid correlated significantly with their utilization, while the resistance for all isolates decreased from 52.16% to 24.40%. Conclusions. These results confirm an association between the use of antibiotics and the prevalence of resistance. This methodology could provide good quality indicators of rational drug use and serve for local monitoring of antibiotics use and resistance, as well as for external comparison.

scholarly journals Impact of Outpatient Antibiotic Use on Carriage of Ampicillin-ResistantEscherichia coli

2010 ◽  
Vol 55 (3) ◽  
pp. 1135-1141 ◽  
Author(s):  
Matthew H. Samore ◽  
Claude Tonnerre ◽  
Elizabeth Lyon Hannah ◽  
Gregory J. Stoddard ◽  
Robert J. Borotkanics ◽  
...  
Keyword(s):  
Drug Class ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Clinic Visit ◽  
Individual Risk ◽  
Competitive Balance ◽  
Household Level ◽  
E Coli ◽  
Group 2 ◽  
Group 1

ABSTRACTStudies about the relationship between antibiotic consumption and carriage of antibiotic-resistantEscherichia coliin individual patients have yielded conflicting results. The goal of this study was to identify individual- and household-level factors associated with carriage of ampicillin (AMP)-resistantE. coliduring consumption of a course of oral antibiotics. We enrolled outpatients and their families in a prospective household study of AMP-resistant or AMP-susceptibleE. colicarriage. Two kinds of index patients were identified. Group 1 consisted of outpatients who were being initiated on a new antibiotic course at the time of a clinic visit, and group 2 consisted of outpatients not starting antibiotics. Each participant was asked to submit three stool swab samples (at baseline, week 1, and week 4) and to complete a questionnaire. Antimicrobial susceptibility testing was performed on each phenotypically distinctE. colicolony. The study included 149 group 1 households (total, 570 participants) and 38 group 2 households (total, 131 participants). AMP-resistantE. coliwas recovered from 29% of stool samples. Observed associations with antibiotic exposure varied by drug class. Penicillins, which were the most frequently prescribed drug class, were associated with a modest increase in AMP-resistantE. colicarriage and a modest decrease in AMP-susceptibleE. colicarriage. Neither change by itself was statistically significant. Macrolides were associated with reduced carriage of both AMP-resistantE. coliand AMP-susceptibleE. coli(P< 0.05). Both AMP-resistant and AMP-susceptibleE. colidemonstrated household clustering (P< 0.001). In summary, the overall effect of antibiotics on individual risk of carriage of AMP-resistantE. coliwas small. However, even a modest alteration of the competitive balance between AMP-resistant and AMP-susceptibleE. colimay promote population spread of resistantE. coli. Examining changes in both resistant and susceptible organisms in antibiotic-treated individuals and their close contacts improves understanding of antibiotic selection pressure.

scholarly journals Evaluation of antibiotic usage in swine reproduction farms in Umbria region based on the quantitative analysis of antimicrobial consumption

2017 ◽  
Vol 6 (3) ◽  
Author(s):  
Fausto Scoppetta ◽  
Marco Sensi ◽  
Maria Pia Franciosini ◽  
Marinella Capuccella
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Diagnostic Methods ◽  
Antibiotic Administration ◽  
Oral Antibiotic ◽  
Defined Daily Doses ◽  
Umbria Region ◽  
Antimicrobial Susceptibility Tests ◽  
Critical Aspects

Antibiotic use in food-producing animals has considerable impact on public health, especially with respect to the development and spread of antibiotic resistance. Pigs represent one of the main species in which antibiotics are frequently used for different purposes. Surveillance of antibiotic consumption and dose appropriateness, through novel approaches based on defined daily doses, is strongly needed to assess farms’ antibiotic risk, in terms of spread of antibiotic resistance and possibile presence of residues in meat. In this study, antibiotic consumption was monitored in 14 swine reproduction farms, together with managerial, structural, and health aspects. Most of the controlled farms (65%) were classified as at medium antibiotic risk, 21% at high antibiotic risk, and 14% at low antibiotic risk. Critical aspects of antibiotic administration concerned treatments for suckling and weaner piglets, oral antibiotic administration, treatment and diagnosis of gastroenteric infections, and use of critically important antimicrobials for human medicine, especially colistin. These aspects could be considered critical aspects of antibiotic use in from-farrow-to-wean/finish swine farms in the Umbria region and must be controlled to minimize risks. Even though a small number of farms in Umbria region are at high antibiotic risk, the risk of antibiotic resistance should be minimized, and management and biosecurity of the farms should be improved by extending the use of antimicrobial susceptibility tests and optimizing the diagnostic methods for infectious diseases. Furthermore, farmers’ and veterinarians’ knowledge of antibiotic resistance should be improved and the prudent use of antibiotics encouraged to prevent the development and spread of resistant microorganisms.

Impact of simplified therapeutic guidelines on antibiotic prescriptions: a prospective multicentre comparative study

2019 ◽  
Vol 75 (3) ◽  
pp. 747-755
Author(s):  
Pierre-Marie Roger ◽  
Ingrid Peyraud ◽  
Michel Vitris ◽  
Valérie Romain ◽  
Laura Bestman ◽  
...  
Keyword(s):  
Clavulanic Acid ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Third Generation ◽  
Therapeutic Guidelines ◽  
Amoxicillin Clavulanic Acid ◽  
The Impact ◽  
Third Generation Cephalosporins

Abstract Objectives We studied the impact of simplified therapeutic guidelines (STGs) associated with accompanied self-antibiotic reassessment (ASAR) on antibiotic use. Methods Prospective antibiotic audits and feedback took place at 15 hospitals for 12 months, allowing STGs with ≤15 drugs to be devised. STGs were explained to prescribers through sessions referred to as ASAR. Optimal therapy was defined by the conjunction of a diagnosis and the drug specified in the STGs. Analysis of consumption focused on critical drugs: amoxicillin/clavulanic acid, third-generation cephalosporins and fluoroquinolones. Results We compared prescriptions in five hospitals before (n = 179) and after (n = 168) the implementation of STGs + ASAR. These tools were associated with optimal therapies and amoxicillin/clavulanic acid prescriptions [adjusted odds ratio (AOR) 3.28, 95% CI 1.82–5.92 and 2.18, 95% CI 1.38–3.44, respectively] and fewer prescriptions for urine colonization [AOR 0.20 (95% CI 0.06–0.61)]. Comparison of prescriptions (n = 1221) from 10 departments of three clinics with STGs + ASAR for the first quarters of 2018 and 2019 revealed that the prescriptions by 23 ASAR participants more often complied with STGs than those by 28 other doctors (71% versus 60%, P = 0.003). STGs alone were adopted by 10 clinics; comparing the prescriptions (n = 311) with the 5 clinics with both tools, we observed fewer unnecessary therapies in the latter [AOR 0.52 (95% CI 0.34–0.80)]. The variation in critical antibiotic consumption between 2017 and 2018 was −16% for the 5 clinics with both tools and +20% for the other 10 (P = 0.020). Conclusions STGs + ASAR promote optimal antibiotic therapy and reduce antibiotic use.

scholarly journals Trends in Antibiotic Self-Medication for Dental Pathologies among Patients in the Dominican Republic: A Cross-Sectional Study

2021 ◽  
Vol 10 (14) ◽  
pp. 3092
Author(s):  
Juan Manuel Aragoneses ◽  
Javier Aragoneses ◽  
Cinthia Rodríguez ◽  
Juan Algar ◽  
Ana Suárez
Keyword(s):  
Dominican Republic ◽  
Clavulanic Acid ◽  
Bacterial Resistance ◽  
Antibiotic Use ◽  
World Health Organisation ◽  
World Health ◽  
Binary Logistic Regression Analysis ◽  
Self Medication ◽  
Cross Sectional ◽  
Amoxicillin Clavulanic Acid

The World Health Organisation has warned of the increase in antibiotic resistance, estimating that by 2050 it could become the leading cause of death worldwide. Several studies and literature reviews show a correlation between antibiotic use and bacterial resistance, with unnecessary broad-spectrum antibiotics, such as amoxicillin/clavulanic acid and azithromycin, being one of the main causative factors. An interview-based survey of 2160 participants was conducted to assess the prevalence in the practice of self-medication with antibiotics among dental patients in the Dominican Republic. A series of open-ended questions regarding self-medication and class of antibiotics were put to the patients. Over a third of the study population (39.7%) admitted to the practice of antibiotic self-medication. Most of the respondents (58.4%) who indulged in self-medication were females, and it was prevalent in the older adults between 32–42 years old (36%). There was a negative correlation between age and self-medication practice (p < 0.001) observed with point biserial correlation test. Binary logistic regression analysis found an odds ratio of 0.97 (p < 0.001). The most consumed antibiotics were amoxicillin/clavulanic acid (52%), amoxicillin (31.1%), and azithromycin (10.1%). It is imperative to educate patients about the harmful effects of self-medication and to stress the need for governments to implement stricter laws on non-prescription drug availability.

scholarly journals Trends and Drivers of Inpatient Antibiotic Consumption among 89 China Tertiary General Hospitals from 2011Q1 to 2015Q4

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Jiangyun Chen ◽  
Rui Min ◽  
He Wang ◽  
Shengwen Zhao ◽  
Haomiao Li ◽  
...  
Keyword(s):  
Antibiotic Stewardship ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Panel Regression ◽  
General Hospitals ◽  
Policy Interventions ◽  
Defined Daily Doses ◽  
Stewardship Program ◽  
Program Policy ◽  
Made In

Antibacterial surveillance is an essential measure for strengthening the management of clinical antibiotic use. This study aimed to determine the trends and drivers of inpatient antibiotic consumption in China. A sample of 89 hospitals with complete data from 2011Q1 to 2015Q4 was included. Accumulative defined daily doses (DDDs), antibiotic use density (AUD), and drug variety were calculated to evaluate antibiotic consumption. From 2011Q1 to 2015Q4, the median values of DDDs, AUD, and drug variety dropped by 10.49%, 39.19%, and 27.96%, respectively. Panel regression results showed, for each additional quarter, DDDs reduced by 6.714 DDDs, AUD reduced by 0.013 DDDs per 100 inpatients per day, and drug variety reduced by 0.012 types (p < 0.001). National hospitals were more likely to use antibiotics, with the highest number of DDDs (106 709 DDDs) and AUD (60 DDDs per 100 inpatients per day) and a large number of drug variety (71 types of drug) all reported from national hospitals. Overall, a downward trend of inpatient antibiotic consumption was observed in competitive tertiary general hospitals in China. However, antibiotic use in China, especially in national hospitals, continues to exceed the guidelines set forth by the nationwide antibiotic stewardship program. China must continue to improve surveillance of antibiotic consumption by constructing a more comprehensive, continuous, and targeted stewardship program. Policy interventions in China should be made in consideration of unbalanced regional development and the consequences this may have on antibiotic consumption.

scholarly journals A between-Species Comparison of Antimicrobial Resistance in Enterobacteria in Fecal Flora

2000 ◽  
Vol 44 (6) ◽  
pp. 1479-1484 ◽  
Author(s):  
Monica Österblad ◽  
Antti Hakanen ◽  
Raija Manninen ◽  
Tiina Leistevuo ◽  
Reijo Peltonen ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Length Of Hospital Stay ◽  
Antibiotic Use ◽  
University Hospital ◽  
Fecal Flora ◽  
E Coli ◽  
Defined Daily Doses ◽  
Hospital Patients ◽  
Resistance Patterns ◽  
Resistance Data

ABSTRACT Enterobacteria in fecal flora are often reported to be highly resistant. Escherichia coli is the main species; resistance data on other species are rare. To assess the effect of the host's environment, antimicrobial resistance was determined in fecal species of the family Enterobacteriaceae from three populations: healthy people (HP)(n = 125) with no exposure to antimicrobials for 3 months preceding sampling, university hospital patients (UP) (n = 159) from wards where the antibiotic use was 112 defined daily doses (DDD)/bed/month, and geriatric long-term patients (LTP) (n = 74) who used 1.8 DDD/bed/month. The mean length of hospital stay was 5 days for the UP and 22 months for the LTP. The isolates were identified to at least genus level, and MICs of 16 antimicrobials were determined. From the university hospital, resistance data on clinicalEnterobacteriaceae isolates were also collected. Resistance data for on average two different isolates per sample (range, 1 to 5) were analyzed: 471 E. coli isolates and 261 otherEnterobacteriaceae spp. Resistance was mainly found amongE. coli; even in HP, 18% of E. coli isolates were resistant to two or more antimicrobial groups, with MIC patterns indicative of transferable resistance. Other fecal enterobacteria were generally susceptible, with little typically transferable multiresistance. Clinical Klebsiella andEnterobacter isolates were significantly more resistant than fecal isolates. The resistance patterns at both hospitals mirrored the patterns of antibiotic use, but LTP E. coli isolates were significantly more resistant than those from UP. Conditions permitting an efficient spread may have been more important in sustaining high resistance levels in the LTP. E. coli was the main carrier of antimicrobial resistance in fecal flora; resistance in other species was rare in the absence of antimicrobial selection.

scholarly journals Quality Appraisal of Ambulatory Oral Cephalosporin and Fluoroquinolone Use in the 16 German Federal States from 2014–2019

Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 831
Author(s):  
Gabriele Gradl ◽  
Johanna Werning ◽  
Salka Enners ◽  
Marita Kieble ◽  
Martin Schulz
Keyword(s):  
Bacterial Resistance ◽  
Antibiotic Use ◽  
Oral Cephalosporin ◽  
Federal States ◽  
Defined Daily Doses ◽  
German Federal States ◽  
City States ◽  
The City ◽  
Dispensing Data

Background: Despite concerns about causing bacterial resistance and serious side effects, oral cephalosporins and fluoroquinolones are still frequently prescribed in Germany. We aimed to test a method for the detection of regional quality differences in the use of oral cephalosporins and fluoroquinolones and to apply this to the German federal states. Methods: Use of antibiotics from 2014–2019 was analyzed using dispensing data from community pharmacies claimed to the statutory health insurance (SHI) funds. Quality of regional antibiotic use in 2019 was assessed by calculating indicators based on defined daily doses per 1000 SHI-insured persons per day (DID). Oral cephalosporin and fluoroquinolone use was followed by linear regression analyses. Results: The method used was suitable to find meaningful quality differences in ambulatory oral cephalosporin and fluoroquinolone use between the German federal states. In 2019, DID varied from 1.62 in Brandenburg to 3.17 in Rhineland-Palatinate for cephalosporins and from 0.47 in Brandenburg to 0.89 in Saarland for fluoroquinolones. The city-states Hamburg, Bremen, and Berlin showed highest quality with the applied indicator set. From 2014–2019, a significant decrease in utilization of oral cephalosporins was found in all federal states. During 2017–2019, all states showed a significant decline of fluoroquinolone use.

scholarly journals Antibiotic resistance profile of commensal Escherichia coli isolated from healthy sheep in Qatar

2020 ◽  
Vol 14 (02) ◽  
pp. 138-145
Author(s):  
Nahla Eltai ◽  
Asmaa A Al Thani ◽  
Sara H Al-Hadidi ◽  
Elmoubasher A Abdfarag ◽  
Hamad Al-Romaihi ◽  
...  
Keyword(s):  
Phosphate Buffer Solution ◽  
Antibiotic Use ◽  
Test Method ◽  
Resistant Bacteria ◽  
Buffer Solution ◽  
E Coli ◽  
Antibiotic Resistance Profile ◽  
Stewardship Program ◽  
Antibiotics Use ◽  
Food Animals

Introduction: The uncontrolled antibiotics use in livestock is a leading factor for the emergence and spread of resistant bacteria from food animals to humans through the food chain. This study aims at evaluating the magnitude of the antimicrobial resistance (AMR) in food animals, acknowledging the lack of information on the prevalence of resistance in the veterinary field in Qatar. Methodology: Rectal samples were collected from 171 sheep across three localities in Qatar between December 2016 and July 2017. These rectal samples were suspended in Phosphate buffer solution (PBS). Then streaked onto a selective CHROMagar E. coli medium plates and incubated at 37°C for 18 to 24 h. Isolated E. coli were tested for antibiotic susceptibility against 16 clinically- relevant antibiotics using the E-test method. Statistical analyses were performed using SPSS statistics 24. Results: E. coli was isolated from 144 samples (84.2%), of which 90% were resistant to at least one antibiotic and 44% were multi-drug resistant (MDR). The highest resistance was against ciprofloxacin 69.4% (100), followed by nitrofurantoin 47.2% (68), trimethoprim/sulfamethoxazole 45.8% (66), cephalothin 43% (62) and amoxicillin/clavulanic acid 18% (26). Low resistance was reported to fosfomycin, amikacin and tigecycline 1.4% (2), 0.7% (1), and 0.7% (1), respectively. Conclusions: We reported high MDR E. coli in rectal swabs of sheep in Qatar. Such resistant bacteria can potentially be transmitted to humans, resulting in public health concerns. This requires a quick response to develop and implement a stewardship program for the monitoring of antibiotic use in the veterinary in Qatar.

scholarly journals Impact of Antibiotic Use on Carbapenem Resistance in Pseudomonas aeruginosa: Is There a Role for Antibiotic Diversity?

2013 ◽  
Vol 57 (4) ◽  
pp. 1709-1713 ◽  
Author(s):  
C. Plüss-Suard ◽  
A. Pannatier ◽  
A. Kronenberg ◽  
K. Mühlemann ◽  
G. Zanetti
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Broad Spectrum ◽  
Carbapenem Resistance ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Content Type ◽  
Defined Daily Doses ◽  
Consumption Data ◽  
Resistance Rates ◽  
The Impact

ABSTRACTIn this study, we aimed to evaluate the relationship between the rates of resistance ofPseudomonas aeruginosato carbapenems and the levels and diversity of antibiotic consumption. Data were retrospectively collected from 20 acute care hospitals across 3 regions of Switzerland between 2006 and 2010. The main outcome of the present study was the rate of resistance to carbapenems amongP. aeruginosa. Putative predictors included the total antibiotic consumption and carbapenem consumption in defined daily doses per 100 bed days, the proportion of very broad-spectrum antibiotics used, and the Peterson index. The present study confirmed a correlation between carbapenem use and carbapenem resistance rates at the hospital and regional levels. The impact of diversifying the range of antibiotics used againstP. aeruginosaresistance was suggested by (i) a positive correlation in multivariate analysis between the above-mentioned resistance and the proportion of consumed antibiotics having a very broad spectrum of activity (coefficient = 1.77; 95% confidence interval, 0.58 to 2.96;P< 0.01) and (ii) a negative correlation between the resistance and diversity of antibiotic use as measured by the Peterson homogeneity index (coefficient = −0.52;P< 0.05). We conclude that promoting heterogeneity plus parsimony in the use of antibiotics appears to be a valuable strategy for minimizing the spread of carbapenem resistance inP. aeruginosain hospitals.

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